The birth of a baby can trigger a jumble of powerful emotions, from excitement and joy to fear and anxiety. But it can also result in something you might not expect — depression.
Many new moms experience the baby blues after childbirth, which commonly include mood swings and crying spells and fade quickly. But some new moms experience a more severe, long-lasting form of depression known as postpartum depression. Rarely, an extreme form of postpartum depression known as postpartum psychosis develops after childbirth.
Postpartum depression isn't a character flaw or a weakness. Sometimes postpartum depression is simply a complication of giving birth. If you have postpartum depression, prompt treatment can help you manage your symptoms — and enjoy your baby.
Symptoms
Signs and symptoms of depression after childbirth vary depending on the type of depression.
Baby blues symptoms
Signs and symptoms of the baby blues — which last only a few days or weeks — may include:
Signs and symptoms of the baby blues — which last only a few days or weeks — may include:
- Mood swings
- Anxiety
- Sadness
- Irritability
- Crying
- Decreased concentration
- Trouble sleeping
Postpartum depression symptoms
Postpartum depression may appear to be the baby blues at first — but the signs and symptoms are more intense and longer lasting, eventually interfering with your ability to care for your baby and handle other daily tasks. Postpartum depression symptoms may include:
Postpartum depression may appear to be the baby blues at first — but the signs and symptoms are more intense and longer lasting, eventually interfering with your ability to care for your baby and handle other daily tasks. Postpartum depression symptoms may include:
- Loss of appetite
- Insomnia
- Intense irritability and anger
- Overwhelming fatigue
- Loss of interest in sex
- Lack of joy in life
- Feelings of shame, guilt or inadequacy
- Severe mood swing
- Difficulty bonding with the baby
- Withdrawal from family and friends
- Thoughts of harming yourself or the baby
Untreated, postpartum depression may last for a year or more.
Postpartum psychosis
With postpartum psychosis — a rare condition that typically develops within the first two weeks after delivery — the signs and symptoms are even more severe. Signs and symptoms of postpartum psychosis may include:
With postpartum psychosis — a rare condition that typically develops within the first two weeks after delivery — the signs and symptoms are even more severe. Signs and symptoms of postpartum psychosis may include:
- Confusion and disorientation
- Hallucinations and delusions
- Paranoia
- Attempts to harm yourself or the baby
When to see a doctor
If you're feeling depressed after your baby's birth, you may be reluctant or embarrassed to admit it. But it's important to call your doctor if the signs and symptoms of depression:
- Don't fade after two weeks
- Are getting worse
- Make it hard for you to care for your baby
- Make it hard to complete everyday tasks
- Include thoughts of harming yourself or your baby
Getting early treatment for postpartum depression can speed your recovery.
If you suspect that you're developing postpartum psychosis, seek medical attention immediately. Don't wait and hope for improvement. Postpartum psychosis may lead to life-threatening thoughts or behaviors.
Causes
There's no single cause for postpartum depression. Physical, emotional and lifestyle factors may all play a role.
Physical changes
The postpartum period is a time of great changes in the body. These changes can affect a woman’s mood and behavior for days or weeks.
Levels of the hormones estrogen and progesterone decrease sharply in the hours after childbirth. This change may trigger depression in the same way that much smaller changes in hormone levels can trigger mood swings and tension before menstrual periods. Some women are more bothered by these changes than others. They may be more likely to have postpartum blues or depression.
Hormone levels produced by the thyroid gland also may decrease sharply after birth. If these levels are too low, the new mother may have depression-like symptoms, such as mood swings, nervousness, fatigue, trouble sleeping, and tension.
Many women feel very tired after giving birth. It can take weeks for a woman to regain her normal strength. Some women have their babies by cesarean birth. Because this is major surgery, it will take them longer to feel strong again.
Also, new mothers seldom get the rest they need. In the hospital, sleep is disturbed by visitors, hospital routine, and the baby’s feedings. At home, the baby’s feedings and care must be done around the clock, along with household tasks. Fatigue and lack of sleep can go on for months. They can be a major reason for depression.
Emotional factors
Many emotional factors can affect a woman’s self-esteem and the way she deals with stress. This can add to postpartum depression.
Feelings of doubt about the pregnancy are common. The pregnancy may not have been planned. Even when a pregnancy is planned, 40 weeks may not be enough time for a couple to adjust to the extra effort of caring for a baby.
The baby may be born early. This can cause changes in home and work routines that the parents did not expect. If the baby is born with a birth defect, it may be even harder for the parents to adjust.
Having a baby who must stay in the hospital after birth can cause sadness and guilt. A woman may feel guilty that she did something wrong during pregnancy. Sadness about coming home without the baby is very common.
Mixed feelings sometimes arise from a woman’s past. She may have lost her own mother early or had a poor relationship with her. This might cause her to be unsure about her feelings toward her new baby. She may fear that caring for the child will lead to pain, disappointment, or loss.
Feelings of loss are common after having a baby. This can add to depression. The loss can take many forms:
- Loss of freedom. This can include feelings of being trapped and tied down.
- Loss of an old identity. The mother may be used to someone else taking care of her or of being in control.
- Loss of prepregnancy shape and feelings of having sex appeal.
Lifestyle influences
A major factor in postpartum depression is lack of support from others. The steady support of a new mother’s partner, other family members, or friends is a comfort during pregnancy and after the birth. It helps when others can assume household chores and share in child care. If a woman lives alone or far away from her family, support may be lacking.
Breast-feeding problems can make a new mother feel depressed. New mothers need not feel guilty if they cannot breast-feed or if they decide to stop. The baby can be well nourished with formula. Your partner or other supportive person can help with some of the feedings, giving you more time for yourself or for rest.
The Role of Myths
Women who have an idea of the “perfect mother” are more likely to feel let down and depressed when faced with the needs of day–to–day mothering. Three myths about being a mother are common:
Myth No. 1: Motherhood Is Instinctive. First-time mothers often believe that they should just know how to care for a newborn. In fact, new mothers need to learn mothering skills just as they learn any other life skill. It takes time and patience. It takes reading child care books, watching skilled child caregivers, and talking with other mothers. As a mother’s skills grow, she will become more sure of herself.
Mothers also may believe that they must feel a certain way toward their newborns or they are not “maternal.” In fact, some women feel very little for their infants at first. Mother love, like mothering skills, does not just happen. Bonding often takes days or even weeks. When the special feelings of motherhood begin to emerge, they should be nurtured.
Myth No. 2: The Perfect Baby. Most women dream about what their newborns will look like. When the baby arrives, it may not match the baby of their dreams.
Also, babies have distinct personalities right from birth. Some infants are easier to care for. Others are fussy, have upset stomachs, and are not easy to comfort. A new mother may find it hard to adjust to the baby.
Myth No. 3: The Perfect Mother. For some women, being perfect is a never-ending goal. A mother may think she is not living up to the ideal. She may feel that she is a failure.
Of course, no mother is perfect. It is not true that every woman can “have it all.” Most women have trouble finding a balance between caring for a new baby and keeping up with household duties, other children, and a job. They often feel this way even with a lot of support.
Risk factors
Postpartum depression can develop after the birth of any child, not just the first. The risk increases if:
- You have a history of depression, either during pregnancy or at other times
- You had postpartum depression after a previous pregnancy
- You've experienced stressful events during the past year, including illness, job loss or pregnancy complications
- You're having problems in your relationship with your spouse or significant other
- You have a weak support system
- You have financial problems
- The pregnancy was unplanned or unwanted
The risk of postpartum psychosis is higher for women who have bipolar disorder.
Complications
Left untreated, postpartum depression can interfere with mother-child bonding and cause family problems. Children of mothers who have untreated postpartum depression are more likely to have behavioral problems, such as sleeping and eating difficulties, temper tantrums and hyperactivity. Delays in language development are more common as well.
Untreated postpartum depression can last up to a year or longer. Sometimes untreated postpartum depression becomes a chronic depressive disorder. Even when treated, postpartum depression increases a woman's risk of future episodes of major depression.
Treatments and drugs
Treatment and recovery time vary, depending on the severity of your depression and your individual needs.
Baby blues
The baby blues usually fade on their own within a few days to weeks. In the meantime, get as much rest as you can. Accept help from family and friends. Connect with other new moms. Avoid alcohol, which can make mood swings worse. If you have an underactive thyroid, your doctor may prescribe thyroid medication.
The baby blues usually fade on their own within a few days to weeks. In the meantime, get as much rest as you can. Accept help from family and friends. Connect with other new moms. Avoid alcohol, which can make mood swings worse. If you have an underactive thyroid, your doctor may prescribe thyroid medication.
Postpartum depression
Postpartum depression is often treated with counseling and medication.
Postpartum depression is often treated with counseling and medication.
- Counseling. It may help to talk through your concerns with a psychiatrist, psychologist or other mental health professional. Through counseling, you can find better ways to cope with your feelings, solve problems and set realistic goals. Sometimes, family or relationship therapy also is helpful.
- Antidepressants. Antidepressants are a proven treatment for postpartum depression. If you're breast-feeding, it's important to know that any medication you take will enter your breast milk. However, some antidepressants can be used during breast-feeding with little risk of side effects for your baby. Work with your doctor to weigh the potential risks and benefits of specific antidepressants.
- Hormone therapy. Estrogen replacement may help counteract the rapid drop in estrogen that accompanies childbirth, which may ease the signs and symptoms of postpartum depression in some women. Research on the effectiveness of hormone therapy for postpartum depression is limited, however. As with antidepressants, weigh the potential risks and benefits of hormone therapy with your doctor.
With appropriate treatment, postpartum depression usually goes away within a few months. In some cases, postpartum depression lasts up to a year. It's important to continue treatment after you begin to feel better, however. Stopping treatment too early may only lead to a relapse.
Postpartum psychosis
Postpartum psychosis requires immediate treatment, often in the hospital.
Postpartum psychosis requires immediate treatment, often in the hospital.
When your safety is assured, a combination of medications — such as antidepressants, antipsychotic medications and mood stabilizers — may be used to control your signs and symptoms. Sometimes electroconvulsive therapy (ECT) is recommended as well. During ECT, a small amount of electrical current is applied to your brain to produce brain waves similar to those that occur during a seizure. The chemical changes triggered by the electrical currents can reduce the symptoms of depression, especially when other treatments have failed or when you need immediate results.
Treatment for postpartum psychosis can challenge a mother's ability to breast-feed. Separation from the baby makes breast-feeding difficult, and some medications used to treat postpartum psychosis aren't recommended for women who are breast-feeding. If you're experiencing postpartum psychosis, a team of health care providers will help you work through these challenges.
Lifestyle and home remedies
Postpartum depression isn't generally a condition that you can treat on your own — but you can do some things for yourself that build on your treatment plan. In fact, taking good care of yourself can help speed your recovery.
- Make healthy lifestyle choices. Include physical activity, such as a walk with your baby, in your daily routine. Eat healthy foods, and avoid alcohol.
- Focus on little things to look forward to during the day. This might be a hot shower, relaxing bath, walk around the block, or visit with a friend.
- Read something uplifting. Since depression may make it difficult to concentrate, choose something light and positive that can be read a bit at a time.
- Indulge in other simple pleasures. Page through a magazine, listen to music you enjoy, sip a cup of tea.
- Rest. Give your child a quiet place to sleep, and try to rest when the baby does.
- Set realistic expectations. Don't pressure yourself to do everything. Scale back your expectations for the perfect household. Do what you can and leave the rest. Ask for help when you need it.
- Make time for yourself. If you feel like the world is coming down around you, take some time for yourself. Get dressed, leave the house, and visit a friend or run an errand. Or schedule some time alone with your partner.
- Avoid isolation. Talk with your partner, family and friends about how you're feeling. Ask other mothers about their experiences. Ask your doctor about local support groups for new moms or women who have postpartum depression.
- Be patient. Know that it may take time to feel better and take one day at a time.
- Be optimistic. Try to think of small things you're grateful for.
Remember, the best way to take care of your baby is to take care of yourself.
Prevention
If you have a history of depression — especially postpartum depression — mention it to your doctor as soon as you find out you're pregnant. Your doctor will monitor you closely for signs and symptoms of depression. Sometimes mild depression can be managed with support groups, counseling or other therapies. In other cases, antidepressants are recommended — even during pregnancy.
After your baby is born, your doctor may recommend an early postpartum checkup to screen for signs and symptoms of postpartum depression. The earlier postpartum depression is detected, the earlier treatment can begin. If you have a history of postpartum depression, your doctor may recommend antidepressant treatment immediately after delivery.
Post Partum Depression for Male
Although many people know that new moms are at increased risk of depression following the birth of a child, new research suggests that about 10 percent of new dads experience the "baby blues," too.
What's more, the researchers found that if the mother experiences postpartum depression, the father is more apt to be depressed also, which puts the baby at a significantly greater risk of developing emotional, behavioral and developmental problems later on, according to the study.
"Pre- and postnatal depression in men is real. The overall rate of depression in fathers was 10.4 percent in our analysis, about twice what we would expect in the general population of men," said the study's lead author, James Paulson, an associate professor and clinical psychologist at Eastern Virginia Medical School in Norfolk.
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